The Natural History of Congenital Heart Disease in Young Adults

Abstract

Under the Heart Disease Program for elementary school children and junior high school students in Osaka City, the cardiac patients found through mass examination are supposed to be checked annually by the program's staff. After their graduation from junior high school, however, the cardiac patients leave our medical jurisdiction. In order to gather information from those graduates, we have mailed and continue to mail questionnaires to them once every 5 years. By analyzing that information, we sought to describe the natural history of congenital heart disease in young adults. The study revealed that among graduates older than 20 years of age as of March 31, 1978, 17.5% underwent initial cardiac surgery; 1.8% were found to have no more cardiac lesions due to spontaneous healing; 12.3% answered that they had no significant changes; 2.0% were found to have deteriorated cardiac lesions and 2.1% of the graduates had died. Eight point one per cent of the graduate did not answer, although minimum data as to whether they were alive or not was gathered. The mortality rates were calculated by using all follow-up data. It was revealed that the mortality rate for cardiac patients under 14 years of age, for those between 15 and 20 years of age and for those older than 21 years of age are 14 times, 6 times and 3 times as high as the general population in each age group, respectively. The mortality rate for those with mild cases of cardiac lesions is 3 times higher than the general population. It is 13 times higher among moderate cases and 77 times higher among severe cases when compared to the general population. © 1982, The Japanese Circulation Society. All rights reserved.